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Skills: Referral processing, Prior authorization, Medical billing, Insurance verification, Medical terminology
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$20/hr–$25/hr
Full-time
high school, bachelor degree
Posted 9h ago
~40 hrs/week
Responsibilities
The specialist is responsible for processing referrals and prior authorizations to ensure patient visits and procedures are covered by payers. They also verify patient eligibility and maintain documentation within the EMR system.
Requirements
Candidates must have a high school diploma and at least two years of experience in medical billing or referrals. Proficiency in medical terminology and strong computer skills are required for this fast-paced environment.
Full job description
Description
Excel Orthopaedic Specialists in Woburn is hiring. We are a busy Orthopedic practice looking to hire a Referral/Authorization Specialists to add to our expanding team. The Referral / Authorization Specialist is responsible for processing referrals and prior authorizations to ensure that patient visits and procedures are covered by various payers.
Proactively reviews OT and PT therapy schedules to determine which patients need referral or prior authorizations
Prepares, processes and tracks referrals and prior authorizations through various payer systems, documents all in eCW per protocol
Makes follow up calls to patients and payers (insurance company, workers comp, etc)
Responds to questions and requests from leadership, providers, payers and patients
Demonstrate professional communication and problem solving with providers and leadership, participate in process improvement and educate teams on updated guidelines and/or process.
Completes other tasks as directed by management.
Attends staff meetings and continuing education
Requirements
High school diploma required, Bachelor’s degree in related field preferred
Minimum of two years’ experience in medical and/or rehab billing and/or referrals/ prior auths
Knowledge of medical terminology required
Demonstrated ability to handle high volume of calls and claims in a fast paced environment
Excellent verbal and written communication skills
Strong computer skills including EMR and MS Office
Our team of fellowship-trained orthopaedic surgeons will work with you on the road to improving your daily life.
Industry
Medical Practices
Company size
51-200 employees
Headquarters
Woburn, Massachusetts
LinkedIn followers
428
At Excel Orthopaedics, our mission is simple: to provide the very best in medical services for those who come to us with orthopaedic problems and injuries, and to treat each patient like a family member.
Offices: 200 Unicorn Park Dr, Woburn, Massachusetts 01801, US
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